Cyclosporine A for severe atopic dermatitis in children. efficacy and safety in a retrospective study of 63 patients

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BackgroundCyclosporine A (CSA) is an immunosuppressant agent widely used in severe atopic dermatitis (AD). However, experience in children is limited.ObjectivesTo assess the efficacy and adverse events of CSA therapy in children.MethodsRetrospective study of children with severe AD treated with CSA between January 2009 and December 2015.ResultsData from 63 patients were collected. Mean age at the beginning of treatment was 8.4 years (±3.6). The median starting dose was 4.27 (±0.61) mg/kg/day. After 4 weeks of treatment, the outcome was excellent in 35% of cases, good in 29% and poor in 36% of the patients. The response was better in patients without eosinophilia (P < 0.05). The median duration of treatment was 4.6 months (range 1.5–21.6). Side-effects were frequent but mild, being more common in patients after longer treatment periods (P < 0.05). Mean time of follow-up was 19.4 months (±12.7). Prolonged remission (>6 months) was observed in 13 patients (20%).LimitsThis is a retrospective review. The follow-up period is limited.ConclusionsOur data confirm that CSA is efficacious and acts rapidly in the majority of children with severe AD. CSA therapy can provide sustained remission in some patients. CSA seems to be well tolerated in children, but strict monitoring is mandatory.

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